milestones, language

Early diagnosis and intervention for babies with hearing loss are essential to normal development. You should request that your newborn be screened for hearing loss before you leave the hospital. If newborn hearing screening is not available at your hospital, ask your doctor, "Why not? It is endorsed by the American Academy of Pediatrics and mandated in 22 states." Hearing loss from many causes can be present at birth; however, some types of hearing loss develop months or years after birth.

As your baby grows, he or she will reach certain milestones in language development. Failure to reach these milestones may mean your baby has a hearing loss or other language or developmental problems.

It is critically important that a child suspected of hearing loss be tested immediately. Hearing testing can be done at any age, down to newborns. Children do not "grow out of" hearing loss. If hearing loss is not addressed with hearing aids or cochlear implants, your child may suffer irreversible damage to speech and language development. This is the reason behind universal hearing screening.

  If your child does not achieve these milestones on time, talk to your doctor or other healthcare provider about a hearing test.

  • cries
  • startles to loud, sudden sounds
2 to 3 months
  • laughs
  • forms sounds in the back of the mouth ("goo")
  • recognizes familiar voices
  • distinguishes changes in tone of voice (questions, happy statements)
4 to 6 months
  • localizes sound (turns head to right or left toward sound)
  • begins to make syllables out of vowel and consonantlike sounds (puts sounds together)
  • makes nonspeech sounds ("raspberries," yelling, squealing, growling)
  • engages in vocal play (practices sounds)
6 to 12 months
  • babbles (repeats syllables two or more times in sequence ("ma-ma-ma")
  • uses facial expression, eye gaze, vocalization and gestures (reaching, pointing) to communicate
  • By 12 months
    • recognizes his or her name
    • understands "no"
    • understands simple instructions
    • gives a toy upon request
12 to 18 months
  • strings sounds together with adultlike speech patterns
  • says first words
  • by 18 months
    • understands 50 words
    • uses up to 20 words, typically in one-word sentences
18 to 36 months
  • understands up to 3,600 words
  • uses up to 900 words, with an average of 3 to 4 words per sentence
  • begins to obey instructions with prepositional phrases ("Put the doll in the carriage.")
  • can tell a story
  • knows his or her name and street on which s/he lives
  • can sing songs

Adapted from Hansen D, Howard SR, Facilitating Early Language, Vero Beach, FL, The Speech Bin, 1992

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